J Korean Soc Radiol.  2021 Jan;82(1):128-138. 10.3348/jksr.2020.0013.

CT Follow-Up of Postoperative Bronchopleural Fistula: Risk Factors for Progression to Chronic Complicated Infection

Affiliations
  • 1Department of Radiology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
  • 2Department of Radiology, Dong-A University College of Medicine, Busan, Korea
  • 3Department of Thoracic Surgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea
  • 4Department of Radiology, Dongnam Institute of Radiological & Medical Sciences Cancer Center, Busan, Korea
  • 5Departments of Internal Medicine, Respiratory Medicine, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea

Abstract

Purpose
We evaluated the risk factors for progression to chronic complicated bronchopleural fistula (BPF) after pulmonary resection using follow-up CT.
Materials and Methods
We retrospectively reviewed 45 cases with BPF that had undergone pulmonary resection during 2010-2018. We compared the clinical and radiological characteristics of those with complicated BPF (n = 24) and those without complicated (sterilized) BPF (n = 21). The clinical and radiological risk factors for progression to chronic complicated BPF were examined by logistic regression analysis.
Results
The thickness of the pleural cavity wall (p = 0.022), the size of the pleural cavity (p = 0.029), and the size increase of BPF on follow-up (p = 0.012) were significantly different between the two groups. The risk factors for progression to chronic complicated BPF were age > 70 years (odds ratio, 6.43; 95% confidence interval, 1.2–33.7), the thickness of the cavity wall > 5 mm (odds ratio, 52.5; 95% confidence interval, 5.1–545.4), and an increase in the size of the pleural cavity on follow-up CT (odds ratio, 12.5; 95% confidence interval, 2.1–73.5), only in the univariate analysis.
Conclusion
The risk factors for progression to chronic complicated BPF can be evaluated using follow-up CT.

Keyword

Fistula; Lobectomy; Pneumonectomy
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